Air pollution is a serious public health issue in Pakistan’s metropolitan cities, including Lahore, Karachi, Faisalabad, Islamabad, and Rawalpindi. Pakistan’s urban areas are vulnerable due to air pollution drivers such as industrial activities, vehicular emissions, burning processes, emissions from brick kilns, urbanization, and other human activities that have resulted in significant human health issues. The purpose of this study was to examine the impact of air pollutants and smog, as well as their causes and effects on human health. The PRISMA technique was used to assess the impact of environmental contaminants on human health. This study looked at air pollution sources and pollutants such as PM_2.5, PM₁₀, CO₂, CO, SO_X, and NO_x from waste combustion and agriculture. The population included people of all ages and sexes from both urban and rural areas of Pakistan. Data were retrieved and analyzed using SRDR⁺ software and Microsoft Excel spreadsheets. The data suggested that Karachi and Lahore had the highest levels of air pollution and disease prevalence, which were attributed to heavy industrial activity and traffic emissions. Smog was a serious concern in Lahore during winter, contributing to the spread of several diseases. Other cities, including Islamabad, Rawalpindi, Jhang, Sialkot, Faisalabad, and Kallar Kahar, were impacted by agricultural operations, industrial pollutants, brick kilns, and urbanization. Due to these drivers of air pollution, some diseases such as respiratory and cardiovascular diseases had notably higher incidences in these cities. Other diseases were connected with air pollution exposure, asthma, eye and throat problems, allergies, lung cancer, morbidities, and mortalities. To reduce air pollution’s health effects, policies should focus on reducing emissions, supporting cleaner technologies, and increasing air quality monitoring.